How Long Does It Take a Sprained Ankle to Heal?

This post was Written by Omnis Rehab Physical Therapist Elizabeth (Betta) Clark, PT, DPT, MS

Have you ever sprained an ankle?

Whether this was a recent mild sprain that had you hurting for a few days or a major sprain that took you out for weeks as a kid, it could be relevant to what you are experiencing with your pain or performance now!

Ankle sprains are generally regarded as a ligament injury, most of the time to the outside ligaments of the foot.  The foot is usually more vulnerable to an inversion sprain (when you fall or trip on a turned in ankle) than an eversion sprain, since you have less muscles of the foot that are able to control inversion. Both sprains are possible however.

Ankle Sprain Treatment

The typical immediate recommendation for an ankle sprain is to rest, ice and elevate (if swelling is associated with it) for at least 48 hours. Often, following these guidelines will allow the person who sprained their ankle to become relatively pain free and functional over the next few weeks.

HOWEVER, what I find clinically with ankle sprains is that the talus bone (one of the bones that forms the foundation of your ankle) will usually slightly shift to the inside or outside of the foot, putting pressure on those ligaments and can continue the swelling and inflammation process long after the ligament should have healed. Many conventional treatment options including sports medicine, rehab, or physical therapy worlds will not address this. I would recommend seeing a professional as soon as possible after a significant ankle sprain, as talus bone shifting can be responsible for some of the immediate symptoms as you’ll see from the anecdote below.

Ankle Sprain Treatments in Practice

I was hiking in Colorado with my friend once when she sprained her ankle about 2 miles out from our car. She was unable to bear any weight on her foot and my options were to either carry her on my back for 2 miles or put my training to use in the wild.  I was able to feel with my hands that her talus bone had shifted significantly to the inside.  I attempted to slightly shift her bone the opposite way while she performed some ankle pumps, and she didn’t like me very much at that moment, but immediately after,[D1]  she was able to bear weight on her foot with significantly less pain and we made it back to our car safely.

The research shows that individuals who have sprained an ankle once are more likely to sprain an ankle in the future1-3.  It has been theorized that this is due to a decreased ability to feel where their joint is in space.  I agree that this is probably true, but I think often their joint “doesn’t know” where it is in space BECAUSE the talus bone has slightly shifted.

Adaptation and Over Compensation

The body will often learn to adapt around this minor shift and cause compensation at the foot, knee, hip or even at your back! Yes, I am implying that your untreated high school ankle sprain may be a contributor to your hip or back pain now.

Of course, the human body is amazingly adaptable and many people function and compensate swimmingly.  Until, that is, life catches up and physical and mental stressors become too much that the body says “hold up! I can’t compensate anymore.”

A great example of this is my husband David who struggled with back pain with simple activities (like putting on his clothes!) for the better part of a year while he was deployed.  He tried lots of different self-care techniques, including soft tissue, dry needling, spinal manipulation, McKenzie  [D1] techniques and deep breathing.  All of these gave some temporary relief. But, his pain kept coming back UNTIL we worked on his ankle.  He had sprained it as a kid playing tennis, and his body adapted around it until it no longer could. To be exact, we found his talus bone was sitting to the inside, presumably from his ankle sprain while playing tennis as a teenager!

Get Started Working towards Feeling Better

If this is your issue, I would recommend a talus mobilization by a professional, followed up with exercise designed to challenge your ankle stability. Although everyone is different, this specific rehab process takes about 3-5 visits on average, depending on how long it has been an issue, along with other factors.

Different people respond differently to similar treatments, and by all means I’m NOT saying that if you had an ankle sprain once, you’re doomed.  But, if you’ve addressed everything else except that on the path to a healthier body, and are still struggling, maybe it’s time to take a deeper look into your past.

Schedule an Appointment with Dr. Clark Today!

sources:

1.Beynnon BD, Murphy DF, Alosa DM. Predictive factors for lateral ankle sprains: a literature review. J Athl Train. 2002; 37: 376– 380. 

2. Swenson DM, Yard EE, Fields SK, Comstock RD. Patterns of recurrent injuries among US high school athletes, 2005-2008. Am J Sports Med. 2009; 37: 1586– 1593. http://dx.doi.org/10.1177/0363546509332500 

3. Yeung MS, Chan KM, So CH, Yuan WY. An epidemiological survey on ankle sprain. Br J Sports Med. 1994; 28: 112– 116.